These fractures are considered unstable due to loss of the lesser trochanter important for weight transfer and loss of greater trochanter, allowing for collapse of the fracture and foreshortening of the neck.
Therefore, extramedullary devices are considered a second choice for fixation. They lack the necessary stability to ensure union in a satisfactory position of all the fragments.
Elderly patients will not mobilize easily with restricted weight bearing. Therefore, procedures allowing for immediate weight bearing as tolerated with walking aids should be selected whenever possible.
In case of symptomatic hip arthritis, total hip arthroplasty may be considered.
These fractures are considered unstable due to loss of the lesser trochanter important for weight transfer and loss of greater trochanter, allowing for collapse of the fracture and foreshortening of the neck.
Therefore, extramedullary devices are considered a second choice for fixation. They lack the necessary stability to ensure union in a satisfactory position of all the fragments.
Elderly patients will not mobilize easily with restricted weight bearing. Therefore, procedures allowing for immediate weight bearing as tolerated with walking aids should be selected whenever possible.
In case of symptomatic hip arthritis, total hip arthroplasty may be considered.
Implants not available, missing infrastructure for surgical intervention, first aid
Disadvantages
Implants not available, missing infrastructure for surgical intervention, first aid
Disadvantages
Patient not fit for surgery
Disadvantages
Patient not fit for surgery
Disadvantages
Risk for intraoperative fracture of lateral femoral wall
A DHS alone has a high risk of postoperative lateral wall fracture and should only be applied with a TSP.
Contraindication
Advantage
Disadvantages
Risk for intraoperative fracture of lateral femoral wall
A DHS alone has a high risk of postoperative lateral wall fracture and should only be applied with a TSP.
Contraindication
Advantage
Disadvantages
Treatment of choice, fracture instability
Further indication
Contraindication
Advantages
Disadvantages
Treatment of choice, fracture instability
Further indication
Contraindication
Advantages
Disadvantages
